DYNAMO: A Phase II Study of Duvelisib (IPI-145) in Patients With Refractory Indolent Non-Hodgkin Lymphoma

Flinn, Ian W, Miller, Carole B, Ardeshna, Kirit M, Tetreault, Scott, Assouline, Sarit E, Mayer, Jiri, Merli, Michele, Lunin, Scott D, Pettitt, Andrew R, Nagy, Zoltan
et al (show 13 more authors) (2019) DYNAMO: A Phase II Study of Duvelisib (IPI-145) in Patients With Refractory Indolent Non-Hodgkin Lymphoma. JOURNAL OF CLINICAL ONCOLOGY, 37 (11). 912-+.

[img] Text
jco.18.00915.pdf - Published version

Download (880kB) | Preview


PURPOSE:Indolent non-Hodgkin lymphoma (iNHL) remains largely incurable and often requires multiple lines of treatment after becoming refractory to standard therapies. Duvelisib was approved by the Food and Drug Administration for relapsed or refractory (RR) chronic lymphocytic leukemia or small lymphocytic lymphoma (SLL) and RR follicular lymphoma (FL) after two or more prior systemic therapies. On the basis of the activity of duvelisib, a first-in-class oral dual inhibitor of phosphoinositide 3-kinase-δ,-γ, in RR iNHL in a phase I study, the safety and efficacy of duvelisib monotherapy was evaluated in iNHL refractory to rituximab and either chemotherapy or radioimmunotherapy. PATIENTS AND METHODS:Eligible patients had measurable iNHL (FL, SLL, or marginal zone B-cell lymphoma) double refractory to rituximab (monotherapy or in combination) and to either chemotherapy or radioimmunotherapy. All were treated with duvelisib 25 mg orally twice daily in 28-day cycles until progression, unacceptable toxicity, or death. The primary end point was overall response rate (ORR) using the revised International Working Group criteria for malignant lymphoma. RESULTS:This open-label, global phase II trial enrolled 129 patients (median age, 65 years; median of three prior lines of therapy) with an ORR of 47.3% (SLL, 67.9%; FL, 42.2%; MZL, 38.9%). The estimated median duration of response was 10 months, and the estimated median progression-free survival was 9.5 months. The most frequent any-grade treatment-emergent adverse events (TEAEs) were diarrhea (48.8%), nausea (29.5%), neutropenia (28.7%), fatigue (27.9%), and cough (27.1%). Among the 88.4% of patients with at least one grade 3 or greater TEAE, the most common TEAEs were neutropenia (24.8%), diarrhea (14.7%), anemia (14.7%), and thrombocytopenia (11.6%). CONCLUSION:In the DYNAMO study, oral duvelisib monotherapy demonstrated clinically meaningful activity and a manageable safety profile in heavily pretreated, double-refractory iNHL, consistent with previous observations. Duvelisib may provide a new oral treatment option for this patient population of which many are elderly and in need of additional therapies.

Item Type: Article
Uncontrolled Keywords: Humans, Lymphoma, Non-Hodgkin, Neoplasm Recurrence, Local, Diarrhea, Isoquinolines, Purines, Anti-Inflammatory Agents, Non-Steroidal, Antineoplastic Combined Chemotherapy Protocols, Enzyme Inhibitors, Administration, Oral, Drug Administration Schedule, Drug Resistance, Neoplasm, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Phosphatidylinositol 3-Kinases, Kaplan-Meier Estimate, Rituximab
Depositing User: Symplectic Admin
Date Deposited: 04 Jun 2019 10:23
Last Modified: 19 Jan 2023 00:41
DOI: 10.1200/JCO.18.00915
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3044385